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Contractor's Application for Payment <br />Owner's Project No.: <br />Engineer's Project No.: <br />Agency's Project No.: <br />6 From 09/29/23 to 10/31/23 <br />A C D E F F1 F2 G H I J K L <br />Item Quantity Units <br />Unit Price <br />($) <br />Value of Bid Item <br />(C X E) <br />($) <br />Quantity Previous <br />Estimate <br />Value Previous <br />Estimate <br />Estimated <br />Quantity <br />Incorporated in <br />the Work <br />Value of Work <br />Completed to Date <br />(E X G) <br />($) <br />Progress Estimate - Unit Price Work <br />City of Little Canada <br />Bolton & Menk, Inc. <br />OMG Midwest, Inc. Minnesota Paving & Materials <br />Twin Lake Boulevard Improvements <br />Owner: <br />0N1.125376 <br />23-04 <br />Engineer: <br />Contractor: <br />Project: <br />Contract: <br />11/01/23 <br />B <br />% of <br />Value of <br />Item <br /> (J / F) <br />(%) <br />Balance to Finish <br />(F - J) <br />($)Description <br />Work Completed <br />Materials Currently <br />Stored (not in G) <br />($) <br />Work Completed <br />and Materials <br />Stored to Date <br />(H + I) <br />($) <br />Contract Information <br />Bid Item <br />No. <br />Application Date:Application Period:Application No.: <br />Previous Estimate <br /> 797,066.26 578,652.99 798,106.11 798,106.11 (1,039.85) <br />48 13.00 EACH 203.83 2,649.79 12.00 2,445.96 13.00 2,649.79 2,649.79 100% - <br />49 10.00 LF 30.09 300.90 10.00 300.90 10.00 300.90 300.90 100% - <br />50 1.00 EACH 2,888.39 2,888.39 2.00 5,776.78 2.00 5,776.78 5,776.78 200% (2,888.39) <br />51 1.00 EACH 3,359.75 3,359.75 - - 0.36 1,200.00 1,200.00 36% 2,159.75 <br />52 10.00 LF 40.12 401.20 20.00 802.40 20.00 802.40 802.40 200% (401.20) <br />53 13.00 EACH 995.13 12,936.69 12.00 11,941.56 12.00 11,941.56 11,941.56 92% 995.13 <br />54 13.00 EACH 204.90 2,663.70 12.00 2,458.80 12.00 2,458.80 2,458.80 92% 204.90 <br />55 3.00 EACH 817.37 2,452.11 3.00 2,452.11 3.00 2,452.11 2,452.11 100% - <br />56 1.00 EACH 351.02 351.02 - - - - - 351.02 <br /> 28,003.55 26,178.51 27,582.34 27,582.34 421.21 <br />57 2.00 EACH 3,309.61 6,619.22 2.00 6,619.22 2.00 6,619.22 6,619.22 100% - <br />58 2.00 EACH 5,114.85 10,229.70 2.00 10,229.70 2.00 10,229.70 10,229.70 100% - <br />59 1.00 EACH 4,061.79 4,061.79 2.00 8,123.58 2.00 8,123.58 8,123.58 200% (4,061.79) <br />60 3.00 EACH 360.51 1,081.53 5.00 1,802.55 5.00 1,802.55 1,802.55 167% (721.02) <br />61 1.00 EACH 9,186.67 9,186.67 1.00 9,186.67 1.00 9,186.67 9,186.67 100% - <br />62 230.00 LF 58.17 13,379.10 243.00 14,135.31 243.00 14,135.31 14,135.31 106% (756.21) <br />63 10.00 LF 114.33 1,143.30 55.00 6,288.15 55.00 6,288.15 6,288.15 550% (5,144.85) <br />64 180.00 SY 58.17 10,470.60 611.00 35,541.87 611.00 35,541.87 35,541.87 339% (25,071.27) <br />65 350.00 LBS 17.05 5,967.50 187.00 3,188.35 187.00 3,188.35 3,188.35 53% 2,779.15 <br /> 62,139.41 95,115.40 95,115.40 95,115.40 (32,975.99) <br />66 3.00 EACH 421.22 1,263.66 2.00 842.44 2.00 842.44 842.44 67% 421.22 <br />67 5.00 EACH 501.46 2,507.30 4.00 2,005.84 4.00 2,005.84 2,005.84 80% 501.46 <br />68 210.00 LF 24.07 5,054.70 176.00 4,236.32 176.00 4,236.32 4,236.32 84% 818.38 <br />69 2.00 EACH 2,186.35 4,372.70 2.00 4,372.70 2.00 4,372.70 4,372.70 100% - <br />70 1.00 EACH 2,066.00 2,066.00 1.00 2,066.00 1.00 2,066.00 2,066.00 100% - <br />71 1.00 EACH 7,060.50 7,060.50 1.00 7,060.50 1.00 7,060.50 7,060.50 100% - <br />72 253.00 LF 60.68 15,352.04 221.00 13,410.28 221.00 13,410.28 13,410.28 87% 1,941.76 <br />73 227.00 LF 64.19 14,571.13 338.00 21,696.22 338.00 21,696.22 21,696.22 149% (7,125.09) <br />74 33.00 LF 181.53 5,990.49 31.00 5,627.43 31.00 5,627.43 5,627.43 94% 363.06 <br />75 3.00 EACH 3,149.14 9,447.42 3.00 9,447.42 3.00 9,447.42 9,447.42 100% - <br />76 2.00 EACH 4,282.43 8,564.86 3.84 16,444.53 3.84 16,444.53 16,444.53 192% (7,879.67) <br />77 1.00 EACH 11,112.26 11,112.26 1.00 11,112.26 1.00 11,112.26 11,112.26 100% - <br />78 1.00 EACH 10,911.68 10,911.68 - - - - - 10,911.68 <br />79 1.00 EACH 2,707.86 2,707.86 1.00 2,707.86 1.00 2,707.86 2,707.86 100% - <br />80 1.00 EACH 15,745.72 15,745.72 1.00 15,745.72 1.00 15,745.72 15,745.72 100% - <br />81 60.00 CY 130.38 7,822.80 40.00 5,215.20 40.00 5,215.20 5,215.20 67% 2,607.60 <br /> 124,551.12 121,990.72 121,990.72 121,990.72 2,560.40 <br />82 69.00 EACH 220.00 15,180.00 69.00 15,180.00 69.00 15,180.00 15,180.00 100% - <br />83 20.00 LF 24.07 481.40 81.00 1,949.67 81.00 1,949.67 1,949.67 405% (1,468.27) <br />84 50.00 CY 45.13 2,256.50 - - - - - 2,256.50 <br />CONSTRUCT DRAINAGE STRUCTURE DESIGN OCS <br />RANDOM RIPRAP CLASS III <br />GRUBBING <br />REMOVE SEWER PIPE (STORM) <br />SALVAGE & REINSTALL RIPRAP <br />TOTAL PART 4: STORM SEWER <br />PART 5: SIDEWALK <br />CONSTRUCT DRAINAGE STRUCTURE DESIGN 2'X3' <br />CONSTRUCT DRAINAGE STRUCTURE DESIGN 48-4022 <br />CONSTRUCT DRAINAGE STRUCTURE DESIGN 60-4022 <br />CONSTRUCT DRAINAGE STRUCTURE DESIGN 60-4020 <br />CONSTRUC DRAINAGE STRUCTURE DESIGN RAIN GUARDIAN <br />15" RC APRON <br />36" RC APRON <br />12" RC PIPE SEWER CLASS V <br />15" RC PIPE SEWER CLASS V <br />36" RC PIPE SEWER CLASS III <br />DIP FITTINGS <br />REMOVE DRAINAGE STRUCTURE <br />REMOVE PIPE APRON <br />REMOVE STORM SEWER PIPE <br />12" RC APRON <br />ADJUST GATE VALVE BOX <br />HORIZONTAL WATERMAIN OFFSET <br />8" WATERMAIN, C900 W/ TRACER WIRE <br />12" WATERMAIN, DIP CL 52 INCL. POLY WRAP <br />4" POLYSTYRENE NSULATION <br />PART 4: STORM SEWER <br />TOTAL PART 3: WATERMAIN <br />RECONSTRUCT SANITARY MANHOLE <br />RECONSTRUCT MANHOLE BENCH & INVERTS <br />CONNECT TO EXISITING WATERMAIN <br />8" GATE VALVE & BOX W/ LOCKING LID AND MUD PLUG <br />8" GATE VALVE & BOX <br />CONNECT TO EXISTING SANITARY PIPE <br />CONNECT TO EXISTING SANITARY STRUCTURE <br />8" PVC SANITARY SEWER, SDR 35 <br />NEW RINGS AND CASTING (SANITARY) <br />SEAL MANHOLE (INFI-SHEILD) <br />TOTAL PART 2: SANITARY SEWER <br />PART 3: WATERMAIN <br />REMOVE FRAME AND RING CASTING (SANITARY) <br />REMOVE SEWER PIPE (SANITARY) <br />TOTAL PART 1: STREETS <br />PART 2: SANITARY SEWER <br />Unit Price <br />EJCDC C-620 Contractor's Application for Payment <br />(c) 2018 National Society of Professional Engineers for EJCDC. All rights reserved.2 of 4 <br />DocuSign Envelope ID: 8A3ECF1B-B2B5-4B94-939B-BC37027CA07D